For many cancer survivors, cannabis is part of the way they manage symptoms such as pain, nausea, and anxiety. Medical marijuana is now legal in 47 states, Washington, D.C., and three U.S. territories, and its use continues to grow among both the general population and cancer survivors. However, despite its increasing use, little is known about how survivors and their health care providers view medical cannabis or how comfortable they are discussing it.
A new study from VCU Massey Comprehensive Cancer Center surveyed 395 cancer survivors and 62 cancer care providers to better understand these perspectives. Published in Cancer Education JournalThe study found that while survivors and medical cannabis providers agree on many aspects of medical cannabis, they differ in their perception of potential risks and comfort in discussing them.
Although both cancer survivors and healthcare providers share some similarities in their perceptions of medical cannabis use, there are also gaps in perceived risk perception and patient-provider communication. ”
Sunny Jung Kim, Ph.D., corresponding author of the study, researcher in VCU Massey’s Cancer Prevention and Control Program, and associate professor in the VCU School of Public Health
For Kim, whose research focuses on cancer survival and pain management, the research grew out of a broader effort to identify treatment alternatives to opioid-based treatments.
“People are exploring different approaches to avoid or reduce long-term opioid use, and cannabis is one of them,” Kim said.
Research results
The study found that cancer treatment providers were significantly more likely than survivors to report awareness of the potential risks of cannabis use (25% vs. 8.4%). At the same time, cancer survivors were far more likely to say they would be comfortable discussing cannabis with their healthcare team than they would be comfortable discussing cannabis with their healthcare provider (68.5% vs. 46.7%). Healthcare providers also had more negative attitudes toward recreational cannabis use than survivors.
Among survivors, those who used cannabis reported higher social well-being, but also lower physical and mental well-being, greater mistrust of the health care system, and lower utilization of health services overall compared to those who had never used cannabis. Survivors of cannabis use had higher rates of smoking, vaping, anxiety, and depression than nonusers, but there were no differences between the groups in chronic pain, alcohol intake, or sleep quality. Whether marijuana is legal in a survivor’s state does not seem to affect whether they use it.
Notably, more than half (57.9%) of survivors who experienced cannabis use began using before their cancer diagnosis, while the remainder began using specifically after their diagnosis, a distinction that may be clinically important, Kim said.
“We see a similar pattern with opioids. Cancer survivors who were already using opioids before diagnosis are more likely to develop dependence and opioid-related problems,” Kim said. “I think the same thing may be true for cannabis. People who were already using cannabis recreationally before being diagnosed with cancer may be more likely to develop addiction or chronic cannabis use problems, so I think that group may need more careful attention.”
What’s next?
“We need stronger clinical evidence to clearly show that the benefits outweigh the potential risks. Standardized clinical guidelines for cannabis use in cancer survivors would also be helpful, and more education and training on the subject would allow health care providers to feel more confident discussing and recommending medical cannabis when appropriate,” Kim said.
Future research should build on that evidence through longitudinal studies using biomarkers and other objective measures, rather than relying solely on self-reported survey data, Kim said.
“Long-term studies are needed to establish causality using biomarkers and objective measures,” Kim said. “Data should not simply be self-reported outcomes; they should be based on long-term follow-up data that incorporate biomarkers and objective measures to assess the actual outcomes of medical cannabis use, rather than perceived outcomes.”
Ultimately, Kim hopes the findings will encourage more open conversations about medical marijuana between cancer survivors and their health care providers.
“Patient-provider communication is very important. Having an open discussion with your provider will help you make an informed decision,” Kim said.
What is medical marijuana?
Medical cannabis refers to marijuana and its derivatives (such as cannabis concentrates and cannabis-infused edibles) used to manage the symptoms and side effects of medical conditions.
Patients commonly use cannabis to manage pain, nausea, anxiety, depression, fatigue, and loss of appetite, but the evidence in cancer survivors is still evolving.
In this study, more than half of the survivors who used cannabis started using it before they were diagnosed with cancer.
collaborator
- Dr. Vanessa B. Shepherd, VCU Massey and VCU School of Public Health Professor, Teresa A. Thomas Memorial Professor of Cancer Prevention and Control
- Farnese M. Mott, MSc, VCU College of Public Health, Department of Social and Behavioral Sciences
- Susan Hong, MD, VCU Massey and VCU School of Medicine Cancer Survivorship Program Director
- Dr. Aaron H. Lichtman, Department of Pharmacology and Toxicology, VCU School of Medicine
- Dr. Hannah Min, VCU Alumni
- Dr. Victor Clark, Research Assistant Professor, University of Rochester Medical Center
sauce:
virginia commonwealth university
Reference magazines:
Kim, S.J. Others. (2026) Perspectives on cannabis use among cancer survivors and cancer care providers: A parallel study. Journal of Cancer Education. DOI: 10.1007/s13187-026-02934-w. https://link.springer.com/article/10.1007/s13187-026-02934-w
